Monitoring steroid replacement therapy in children with congenital adrenal hyperplasia
-
Niels H. Birkebaek
,
David M. Hougaard
Abstract
Background:
The objective of this study was to compare the analysis of 17-hydroxyprogesterone (17-OHP) by radio-immunoassay (RIA) in serum with analysis by liquid chromatography tandem mass spectrometry (LC-MS/MS) on dried blood spot samples (DBSS) for monitoring therapy in children with congenital adrenal hyperplasia (CAH), and to investigate differences in 17-OHP values during the day.
Methods:
Fourteen children (8 females), median age 4.2 (0.3–16.0) years, were studied. Serum samples and DBSS were drawn before hydrocortisone dosing.
Results:
17-OHP by LC-MS/MS in DBSS were highly correlated to 17-OHP by RIA in serum, r=0.956, p<0.01. A total of 26 three-time-point series were investigated. Using only the afternoon 17-OHP values to determine the hydrocortisone doses would have led to overdosing seven times and underdosing six times.
Conclusions:
Good agreement was demonstrated between 17-OHP determination by RIA in serum and LC-MS/MS on DBSS. Multiple 17-OHP measurements per day are required to ensure sufficient hydrocortisone dose adjustment.
Acknowledgments
The authors wish to thank the specialist nurses Lene S. Poulsen and Lisbeth M. Pedersen for practical coordination of the blood sampling.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report or in the decision to submit the report for publication.
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Articles in the same Issue
- Frontmatter
- Editorial
- Disorders of sex development
- Original Articles
- Fertility and sexual function: a gap in training in pediatric endocrinology
- Disorders of sex development in children in KwaZulu-Natal Durban South Africa: 20-year experience in a tertiary centre
- Novel mutations of the SRD5A2 and AR genes in Thai patients with 46, XY disorders of sex development
- Sensitivity and specificity of different methods for cystic fibrosis-related diabetes screening: is the oral glucose tolerance test still the standard?
- Anti-hyperglycemic activity of Aegle marmelos (L.) corr. is partly mediated by increased insulin secretion, α-amylase inhibition, and retardation of glucose absorption
- Risk factors that affect metabolic health status in obese children
- Nocturnal levels of chemerin and progranulin in adolescents: influence of sex, body mass index, glucose metabolism and sleep
- Elevated endogenous secretory receptor for advanced glycation end products (esRAGE) levels are associated with circulating soluble RAGE levels in diabetic children
- Food exchange estimation by children with type 1 diabetes at summer camp
- Usefulness of non-fasting lipid parameters in children
- Monitoring steroid replacement therapy in children with congenital adrenal hyperplasia
- Clinical and molecular characterization of Beckwith-Wiedemann syndrome in a Chinese population
- An analysis of the sequence of the BAD gene among patients with maturity-onset diabetes of the young (MODY)
- Case Reports
- Hypogonadotropic hypogonadism in a female patient with congenital arhinia
- Transdermal testosterone gel for induction and continuation of puberty in adolescent boys with hepatic dysfunction
- Long-term response to growth hormone therapy in a patient with short stature caused by a novel heterozygous mutation in NPR2
- Three cases of Japanese acromicric/geleophysic dysplasia with FBN1 mutations: a comparison of clinical and radiological features
